2016
DOI: 10.1016/j.ijcard.2016.05.032
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Relation between fractional flow reserve value of coronary lesions with deferred revascularization and cardiovascular outcomes in non-diabetic and diabetic patients

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Cited by 21 publications
(15 citation statements)
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“…Conversely, those patients with a high FFR and normal microvascular function (high CFR, low IMR) had excellent outcomes. Thus, based upon this study, abnormal microvascular function may in part explain the worse outcomes in DM patients despite the absence of FFR detected ischemia, as has been recently described in several studies [3537]. Whether the addition of complementary hemodynamic assessments in DM patients with negative FFR assessments, may result in a more accurate deferred revascularization needs to be studied in larger dedicated studies and the development of repeatable methods of absolute coronary flow measurement may finally help to provide a better understanding of coronary microcirculation [49].…”
Section: Microvascular Disease and Dmsupporting
confidence: 73%
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“…Conversely, those patients with a high FFR and normal microvascular function (high CFR, low IMR) had excellent outcomes. Thus, based upon this study, abnormal microvascular function may in part explain the worse outcomes in DM patients despite the absence of FFR detected ischemia, as has been recently described in several studies [3537]. Whether the addition of complementary hemodynamic assessments in DM patients with negative FFR assessments, may result in a more accurate deferred revascularization needs to be studied in larger dedicated studies and the development of repeatable methods of absolute coronary flow measurement may finally help to provide a better understanding of coronary microcirculation [49].…”
Section: Microvascular Disease and Dmsupporting
confidence: 73%
“…Conversely in non-DM patients, deferred revascularization appeared to be as safe as reported in prior studies, with low rates of future target vessel MI and TLR. Recently, Liu et al [37] have confirmed these findings and have shown that amongst those patients with an FFR >0.85, diabetics had a more than two-fold higher risk of death and MI than non-diabetics, HR 2.20 (95% CI 1.19–4.01, p = 0.015). In addition, this study also reported that among non-diabetic patients with deferred PCI based upon a FFR >0.80, higher FFR values (closer to 1.0) were associated with lower rates of death, MI and revascularization.…”
Section: Ffr and Diabetes Mellitusmentioning
confidence: 82%
“…Based upon the results of landmark trials, deferred revascularization in those lesions with a FFR >0.80 is associated with a low risk of future adverse cardiac outcomes . However, more recently, several studies have shown that deferred revascularization based on FFR assessment of intermediate lesions in high risk patients and specifically in DM patients may not be as safe and is associated with worse outcomes than in non‐DM patients .…”
Section: Discussionmentioning
confidence: 99%
“…Whilst fractional flow reserve (FFR) has an extensive evidence base, a low proportion of patients with DM were included in the landmark studies . Recent evidence has suggested that deferred revascularization based upon FFR in DM patients may not be associated with a similar low risk of MI or target lesion revascularization as seen in non‐DM patients . Whilst risk prediction models have been developed to better predict the risk of FFR‐guided deferred lesion failure (DLF), such models may not be as applicable in DM patients, given the significantly different nature of atherosclerosis seen in this condition .…”
Section: Introductionmentioning
confidence: 99%
“…Comparing FFR-guided deferred revascularization in patients with and without diabetes, Kennedy et al also showed that those with diabetes were associated with a significantly higher rate of target lesion failure [29]. Accordingly, a recent study by Liu et al showed that a higher FFR was associated with lower rates of death, myocardial infarction and revascularization among non-diabetic patients with deferred PCI, but in diabetic patients with deferred revascularization, FFR was not able to differentiate the risk of cardiovascular events [30]. …”
Section: Discussionmentioning
confidence: 99%